Daily Medication Management and Adherence in the Polymedicated Elderly: A Cross-Sectional Study in Portugal.

Daniel Gomes,Daniel Gomes,Fátima Lima,Odete Amaral,Rita Mó,João Lindo Simões,Isabel Fernandes,Fátima Roque,Fátima Roque,Maria Teresa Herdeiro,Manuel Morgado,Manuel Morgado,Manuel Morgado,Ana Isabel Placido,Adolfo Figueiras,Adolfo Figueiras

doi:10.3390/ijerph17010200

Abstract

The presence of age-related comorbidities prone elderly patients to the phenomenon of polypharmacy and consequently to a higher risk of nonadherence. Thus, this paper aims to characterize the medication consumption profile and explore the relationship of beliefs and daily medication management on medication adherence by home-dwelling polymedicated elderly people. A questionnaire on adherence, managing, and beliefs of medicines was applied to polymedicated patients with ≥65 years old, in primary care centers of the central region of Portugal. Of the 1089 participants, 47.7% were considered nonadherent. Forgetfulness (38.8%), difficulties in managing medication (14.3%), concerns with side effects (10.7%), and the price of medication (9.2%) were pointed as relevant medication nonadherence-related factors. It was observed that patients who had difficulties managing medicines, common forgetfulness, concerns with side effects, doubting the need for the medication, considered prices expensive, and had a lack of trust for some medicines had a higher risk of being nonadherent. This study provides relevant information concerning the daily routine and management of medicines that can be useful to the development of educational strategies to promote health literacy and improve medication adherence in polymedicated home-dwelling elderly.

Highlights

According to the United Nations (UN), the number of elderly (≥65 years) will double until 2050 [1].One of the reasons explaining the worldwide ageing of population is the exponential technological contributions in the medicine and public health field, leading to an increase in life expectancy and decrease of mortality rate [2,3]
The sample population of the study was calculated based on the number of elderly patients that are registered in primary care centers and an estimated prevalence of elderly with medication misadventures of 30%
Nonadherence was attributed to forgetfulness, difficulties in managing medication, concerns with side effects, the price of medication, doubt about the need for the medication and the lack of trust for some medicines, showing that elderly’s behaviors, beliefs, and attitudes have an impact on medication adherence

Summary

Introduction

According to the United Nations (UN), the number of elderly (≥65 years) will double until 2050 [1].One of the reasons explaining the worldwide ageing of population is the exponential technological contributions in the medicine and public health field, leading to an increase in life expectancy and decrease of mortality rate [2,3]. According to the United Nations (UN), the number of elderly (≥65 years) will double until 2050 [1]. The use of multiple medication contributes to an incorrect use of medicines by the elderly and may potentially increase the risk for a. Drug Related Problems (DRPs) occurrence, interfering with the treatment effectiveness and safety [8,9,10]. In this context, DRPs in the elderly account for a large percentage of emergency treatment and hospitalizations, increasing the costs with health in the most aged regions [11,12,13]. Levels of adherence to drug therapy correlate inversely with the number of drugs prescribed, especially in the elderly who do not live in nursing homes [8,14]

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